AB1007 NEUROPATHIC PAIN AS A PREDICTOR OF FUNCTIONAL DISORDERS IN PATIENTS WITH ANKYLOSING SPONDYLITIS
Authors: I. Kedyk, M. Stanislavchuk
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Ankylosing spondylitis (AS) is one of the most actual problems in modern rheumatology. AS is characterized by a violation of functional abilities, which causes a decrease in the quality of life and invalidation of patients. The main symptom of AS is chronic pain, which persists in some cases not only due to inflammation, but also due to the neuropathic component of pain, however, this issue needs additional investigation [1]. <h3>Objectives</h3> To assess functional status and its association with neuropathic pain in patients with AS. <h3>Methods</h3> Following the principles of biomedical ethics, on the basis of informed consent, we clinically examined 133 patients (men - 71%) diagnosed with AS according to the modified New York criteria. The presence of neuropathic pain (NP) was assessed by the Leeds Neuropathic Pain Rating Scale (LANSS) and by the Diagnostic Questionnaire for Neuropathic Pain (DN4). Disease activity was assessed by the BASDAI (Bath Ankylosing Spondylitis Disease Assessment Index) and ASDAS (Ankylosing Spondylitis Disease Activity Score). Functional disorders in AS were evaluated according to the BASFI (Bath AS Functional Index) and BASMI (Bath Ankylosing Spondylitis Metrology Index). The HAQ (Health Assessment Questionnaire) questionnaire was used to assess functional capabilities. Statistical analysis was carried out by the methods of variational statistics in the SPSS22 software package (©SPSS Inc.). Significance of differences between groups (p) was measured using the Mann-Whitney test. Results are presented as mean with standard deviation (M±SD). <h3>Results</h3> In patients with AS, the prevalence of NP according to the LANSS was 34.8%. Presence of NP in women was found significantly more often than in men: 52.3% versus 31.1%. According to DN4 data, 37.7% of patients have NP, and the ratio of women to men is 59.1 to 32.2. The NP according to both scales was found in 33.1% of AS patients, significantly more often in women than in men: 51.4% versus 29.7%. Moderate and high disease activity according to the BASDAI and ASDAS prevailed in our patients, and the average values were at the level of 5.5±1.7 and 3.54±0.83, respectively. Functional impairment according to the BASMI in patients with NP was significantly higher in comparing with the group without NP (4.0±2.1 versus 5.1±2.2; p&lt;0.01). At the same time, according to the BASMI, it was established that among all patients with AS, the absence of functional disorders occurred only in 7.0% of patients, moderate disorders - in 68.3%, and severe disorders - in 24.7 % of patients. Pronounced functional disorders prevailed in the group of patients with NP (39.6% vs. 17%). Similar data were obtained by the BASFI (4.3±2.1 versus 6.6±1.6; p&lt;0.01). The presence of functional disorders according to the BASFI was found in 70.7% of all AS patients. At the same time, functional disorders were found in 93.2% of patients with NP. The functional disability according to the HAQ in patients with NP was significantly higher than in the group without NP, which indicates that NP is associated with more pronounced functional disorders - 1.23±0.45 versus 0.91±0.51 (p&lt;0, 01). <h3>Conclusion</h3> The presence of NP in AS patients is a common phenomenon. NP has a close relationship with functional abilities in patients with AS and can be consider as a predictor of severe functional disorders. <h3>Reference</h3> [1]Zhou, L., Li, T., Wu, X., Lu, H., Lin, L., Ye, L., Yin, J., Zhao, J., Wang, X., Bian, J., &amp; Xu, H. (2021). Assessment of Neuropathic Pain in Ankylosing Spondylitis: Prevalence and Characteristics. <i>Pain and therapy</i>, <i>10</i>(2), 1467–1479. https://doi.org/10.1007/s40122-021-00310-8 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.